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Most States Fail to Fully Track Assisted Living Abuses

A GAO report calls for more oversight to help protect residents

Two people walk down the hallway of an assisted living facility

Willie B. Thomas/Getty Images

The investigators recommended clarification of state requirements and annual reporting of critical incidents.

State Medicaid agencies are required to protect the health and welfare of residents in their assisted living facilities, including monitoring cases of abuse, neglect or exploitation. Yet 26 state agencies could not tell federal investigators how many critical incidents of this kind had occurred in the homes and other places under their supervision, the U.S. Government Accountability Office reported this week.

State agencies also varied in what types of incidents they monitored, the GAO found. “A number of states did not identify other incidents that may indicate potential harm or neglect, such as medication errors [seven states] and unexplained death [three states],” says the report titled “Medicaid Assisted Living Services.”

“Thirty-four states made information about critical incidents available to the public by phone, website or in person,” the report says, “while another 14 states did not have such information available at all.”

The reporting gaps prompted the GAO to recommend that federal officials keep a closer watch on state agencies to see that they properly monitor conditions in nursing homes and other facilities to protect residents.

The investigators recommended clarification of state requirements and annual reporting of critical incidents. Officials at the Department of Health and Human Services concurred with the need to clarify and said they would consider requiring yearly state reports.

Agencies in 48 states reported spending more than $10 billion on assisted living services in 2014, covering more than 330,000 beneficiaries.

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